Premium
Impact of macronutrient content of meals on postprandial glucose control in the context of closed‐loop insulin delivery: A randomized cross‐over study
Author(s) -
Gingras Véronique,
Bonato Lisa,
Messier Virginie,
RoyFleming Amélie,
Smaoui Mohamed R.,
Ladouceur Martin,
RabasaLhoret Rémi
Publication year - 2018
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13445
Subject(s) - postprandial , insulin , meal , context (archaeology) , carbohydrate , endocrinology , medicine , crossover study , area under the curve , bolus (digestion) , biology , paleontology , placebo , alternative medicine , pathology
The aim of this randomized four‐way cross‐over study was to examine the effect of added protein and/or fat in standard meals with a fixed carbohydrate content on postprandial glucose control with closed‐loop insulin delivery in adults with type 1 diabetes. Participants (n = 15) consumed breakfast meals with a fixed carbohydrate content (75 ± 1 g) and added protein and/or fat (35 ± 2 g): (1) carbohydrate‐only (standard), (2) high protein (HP), (3) high fat (HF) and (4) high fat + protein (HFHP). The closed‐loop insulin delivery algorithm generated insulin bolus and infusion rates. The addition of fat, protein or both did not impact 5‐hour post‐meal sensor glucose area under the curve (AUC) (main outcome), mean sensor glucose or glycaemic peak as compared with a standard meal ( P > 0.05). However, time to glycaemic peak was delayed by 40 minutes ( P = 0.03 ) and 5‐hour post‐meal basal insulin requirements were 39% higher ( P = 0.04) with an HFHP meal compared with a standard meal. In conclusion, in the context of closed‐loop insulin delivery, protein and/or fat meal content affects the timing of postprandial glycaemic peak, insulin requirements and late glycaemic excursion, without impacting overall 5‐hour AUC.